What's New in Health Care Reform provides an overview of the past week’s news, updates, and commentary in health care reform and utilization management.
House Republicans Unveil Changes to Their Health-Care Bill
House Republican leaders, racing toward a planned vote on their proposed health-care overhaul, unveiled changes to the legislation that they think will win over enough members to secure its passage. The tweaks addressed numerous GOP concerns about the legislation, ranging from the flexibility it would give states to administer their Medicaid programs to the amount of aid it would offer older Americans to buy insurance. They are the product of two weeks of negotiations that stretched from the Capitol to the White House to President Trump’s Florida resort. Via Washington Post.
Trump to Address House GOP as Chamber Charges toward Vote
President Donald Trump is set to address House Republicans at a conference meeting, as GOP leaders hope the president’s dealmaking pedigree could help shore up support for their health care bill before a vote. The vote to repeal and replace significant parts of the Affordable Care Act, coincidentally scheduled for the ACA’s seventh anniversary, would be the first major congressional vote of Trump’s presidency, and Republicans have much on the line after seven years of promising to overhaul the 2010 health care law. Republicans see the president as someone who can convince wary party members to back the legislation. Via Morning Consult.
GOP Health Plan Has Its Own Financial Stick to Prod People to Buy Insurance
The Affordable Care Act's tax penalty for people who opt out of health insurance is one of the most loathed parts of the law, so it is no surprise that Republicans are keen to abolish it. But the penalty, also called the individual mandate, plays a vital function: nudging healthy people into the insurance markets, where their premiums help pay for the cost of care for the sick. Republican lawmakers think they have a better alternative. The GOP approach is called a "continuous coverage" penalty. It increases the cost of the premiums for anyone buying an individual insurance policy if they have gone 63 or more consecutive days without health insurance in the previous 12 months. Via NPR.
Already on Peril, Rural Hospitals Unsure on Health Care Bill
That story is reflected nationwide—rural hospitals have long struggled, with patients who are older, suffer from chronic illnesses, and face few insurance options, if they’re insured at all. Most rural hospitals have a higher-than-normal percentage of Medicaid patients; expected cuts to the federal program for low-income residents will affect facilities everywhere, but experts and administrators are particularly worried about rural areas. Still more rural patients are on Medicare, for those 65 and older, but both programs’ reimbursements are lower than the cost of care. Via STAT.
Republicans at Odds over How to Overhaul Medicaid
The House GOP health care bill has competition from other Republicans, a group of governors who've made their own proposal about how to overhaul Medicaid for low-income people. They're hoping GOP senators will find their ideas more persuasive. It's a gradual approach, with additional options for states. It's likely to involve more federal spending than the House bill, but also keep more people covered. In the end, though, the governors are still talking about fundamental change. Via MPR.
The Sleeping Giants of the Obamacare Debate: Republican Moderates in the House
Arch conservatives have come to define the House Republican brand this decade, pushing the Treasury to the edge of default in 2011, shutting down the government in 2013 and supporting the most right-wing contenders in last year’s presidential primary. Now, however, Speaker Paul D. Ryan (R-Wis.) is dealing with a different rebellious flank within the House Republican Conference as he pushes a massive health-care bill toward the floor next week. Larger in number but softer in tone than their conservative counterparts, moderate Republicans are shaping up to be at least as big a hurdle to achieving the long-held goal of repealing the 2010 Affordable Care Act and replacing it with a more market-oriented series of policies. Via Washington Post.
Next up in House: Health Insurance across State Lines
House Energy and Commerce Committee chairman Greg Walden is teeing up one of the next bills in the Republicans' "Phase 3" of replacing Obamacare: selling health insurance across state lines. The health subcommittee is preparing to hold a hearing on the idea in the next few weeks, probably before the Easter recess, a committee aide tells Axios. One bill that would likely be part of the discussion is Rep. Marsha Blackburn's bill to allow people to buy health insurance from other states. Via Axios.
Obamacare Pushed Nonprofit Hospitals to Do Good beyond Their Walls. Now What?
Requiring this “community health needs assessment” was part of a broader package of rules included in the health law to ensure that nonprofit hospitals justify the tax exemption they receive. Another directive was that these facilities establish public, written policies about financial assistance available for medically necessary and emergency care and that they comply with limits on what patients who qualify for the aid can be charged. These requirements add to the ongoing controversy about whether all nonprofit hospitals do enough to deserve a tax break. People on one side of the issue view the assessment rule, for instance, as an undue, unfunded burden while others say it doesn’t do enough. So far, though, the community health assessment requirement hasn’t exactly been a hot topic in the repeal-and-replace debate and was not addressed by the House Republicans’ health plan unveiled March 6. Via Kaiser Health News.
NIH Would See Huge Budget Cut under President’s Proposal
The National Institutes of Health would absorb an enormous $5.8 billion cut under President Trump’s first budget proposal—equal to about 19% of its current $30.3 billion discretionary budget. The plan “includes a major reorganization” of NIH’s 27 institutes and centers and would eliminate the Fogarty International Center, a $69.1 million program dedicated to building partnerships between health research institutions in the United States and abroad. Via Washington Post.
Trump Unveils "Hard Power" Budget That Boosts Military Spending
Trump wants lawmakers to boost military spending in the coming fiscal year by 10 percent, or $54 billion. Rather than raise taxes or increase the deficit, the president is calling for equivalent cuts in other areas. Foreign aid would be especially hard hit, with the State Department's budget cut by about 28%. Alongside Defense, the agencies for which the White House proposes spending increases are almost entirely military- and national security-related. The Department of Homeland Security would see a hike in funding of 6.8%, as would the Department of Veterans' Affairs (5.9%) and the National Nuclear Security Administration (11.3%). Via NPR.